Information Collection Request

[NCEZID] Validated Interview and Survey of Outpatient Providers on Antibiotic Stewardship Interventions

ICR 202306-0920-007 · OMB 0920-1308 · Historical Active

Forms and Documents

Forms and supporting documents for this ICR
DocumentTypeStatusAvailability
Survey Form and Instruction Modified Available
Survey Form and Instruction Modified Repair queued
SupSta A 0920-1308 Antibiotic Stewardship Interventions_final.docx Supporting Statement A Uploaded 2023-06-15 Repair queued
Attachment 5 Data Collection Recruitment E-mail Templates.docx Supplementary Document Uploaded 2023-06-15 Available
Attachment 4 IRB Letter.pdf Supplementary Document Uploaded 2023-06-15 Repair queued
Attachment 2 60 Day FRN.pdf Supplementary Document Uploaded 2023-06-15 Repair queued
Attachment 1 Authorizing Legislation.pdf Supplementary Document Uploaded 2023-06-15 Repair queued
SupSta B 0920-1308 Antibiotic Stewardship Interventions.docx Supporting Statement B Uploaded 2023-06-15 Repair queued

IC Document Collections

Information collection document groups
IC IDCollectionTypeStatusForm
242164 Survey Form and Instruction ModifiedSurvey
242164 Survey Form and Instruction Modified
242163 Interview guide Other-Interview guide Modified

ICR Details

Reginfo record details
table that charts list comparision
  Inventory as of this Action Requested Previously Approved
08/31/2024 12 Months From Approved
290 0 0
123 0 0
0 0 0





Reginfo record details
2
table that charts list of burden
IC Title Form No. Form Name
Interview guide
Survey n/a

table that charts list of burden
  Total Approved Previously Approved Change Due to New Statute Change Due to Agency Discretion Change Due to Adjustment in Estimate Change Due to Potential Violation of the PRA
Annual Number of Responses 290 0 0 0 0 290
Annual Time Burden (Hours) 123 0 0 0 0 123
Annual Cost Burden (Dollars) 0 0 0 -14,998 0 14,998


Reginfo record details
  No